Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091 Zurich, Switzerland.
Eur J Dermatol. 2011 Mar-Apr;21(2):229-33. doi: 10.1684/ejd.2010.1238.
Atypical Spitz tumors can hardly be differentiated from spitzoid melanoma. CGH might help in the differential diagnosis. An 8 year old child with an atypical Spitz tumor (with a CGH pattern compatible with melanoma) of 8.0 mm Breslow thickness and micrometastases in two lymph node regions was seen at our department. The management and prognosis of atypical Spitz tumors is controversial, and aggressive procedural steps similar to melanoma are usually not recommended. Even performing sentinel lymph node biopsy has been questioned. After extensive interdisciplinary consultations, we did not recommend resection of both lymph node regions and chose instead to follow-up with regular whole-body MRI and adjuvant treatment with pegylated interferon. Treatment decisions for atypical Spitz tumors are a major medical and ethical challenge due to the limited available data.
非典型 Spitz 肿瘤很难与 Spitz 样黑色素瘤区分。CGH 可能有助于鉴别诊断。我们科室曾诊治过一例 8 岁儿童，患有 8.0mm Breslow 厚度的非典型 Spitz 肿瘤（CGH 模式与黑色素瘤相符），且有两个淋巴结区域存在微转移。非典型 Spitz 肿瘤的处理和预后存在争议，通常不建议采取类似于黑色素瘤的激进治疗步骤。甚至有人质疑是否需要进行前哨淋巴结活检。经过广泛的多学科咨询，我们不建议切除两个淋巴结区域，而是选择定期进行全身 MRI 随访，并辅助使用聚乙二醇干扰素进行治疗。由于数据有限，非典型 Spitz 肿瘤的治疗决策是一个重大的医学和伦理挑战。
